Shadows of R.D. Laing

The Observer discusses the recent and somewhat lonely death of Adam Laing, the son of revolutionary psychiatrist R.D. Laing, in an article tinged with both sadness and irony.

Adam Laing was apparently found alone in a remotely pitched tent on the Spanish island of Formentera, surrounded by mostly emptied bottles of alcohol, having had a heart attack during a drinking binge.

R.D. Laing was famously troubled himself, suffering from both alcoholism and depression, and for a psychiatrist that specialised in the influence of the family on mental health, he was a notoriously absent father.

He is often, rather clumsily, associated with ‘anti-psychiatry’. Although he rejected the label himself and was certainly not against psychiatric treatment, he did propose some radical ideas that chimed with the counter-culture of the 1960s.

One of this most important contributions was suggesting that family dynamics had an influence on the development and expression of psychosis.

In many ways his ideas were the forerunner of subsequent work on psychosis and ‘expressed emotion’ – another clumsy term that is used to described the extent to which family members talk about another family member in a critical or hostile manner or in a way that indicates marked emotional over-involvement.

In a now widely replicated finding, the number of critical and undermining comments made in a family to a person with psychosis is known to predict the chance of relapse. This has led to the development of family therapy for psychosis which has been shown to reduce relapse rates.

Laing was more concerned with the development of psychosis and argued that the content of hallucinations and delusional beliefs often reflected thoughts that would otherwise be inexpressible in the fraught emotion of a dysfunctional family.

Perhaps Laing’s most naive, and ironically, most popular essays, The Politics of Experience and The Bird of Paradise suggested that madness was a quasi-mystical state in which the psychotic person had been thrown into a process of ‘ego transcendence’.

Psychosis was, therefore, a process of catharsis and the person should be guided on their journey, rather than treated to moderate their chaotic mental state.

For some people, this is almost certainly true, but these people are sadly in the minority. Most find psychosis a disturbing experience and we there is now accumulating evidence that outcome is far worse for people who have longer periods of untreated psychosis.

Laing was important in pointing out that the mental health system can often add to the disturbing experiences rather than temper them, but he often wandered off into vaguely focused anti-authoritarian diatribes in both his writing and talks which made him a darling of the underground but which obscured his more valuable insights.

The Observer article discusses the contrast between Laing’s work and his difficult personality and family life.

Like this one, it’s an article on the death of a man that largely talks about his long departed father.

It’s difficult to read without being struck by the irony that even in death, R.D. Laing’s work and personality have overshadowed his family life.

Link to Observer article on Laing (thanks Tom and Karel!).

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